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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: MEDIVANCE, INC. ¿ 1725056 UNKNOWN ARCTICGEL PADS

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MEDIVANCE, INC. ¿ 1725056 UNKNOWN ARCTICGEL PADS Back to Search Results
Catalog Number UNKNOWN
Device Problem Patient Device Interaction Problem (4001)
Patient Problems Skin Discoloration (2074); Pressure Sores (2326); Blister (4537); Skin Inflammation/ Irritation (4545); Unspecified Tissue Injury (4559)
Event Date 03/09/2022
Event Type  Injury  
Manufacturer Narrative
The investigation is still in progress.Once the investigation is complete a supplemental report will be filed.The device was not returned.
 
Event Description
It was reported that the patient had some blisters under breasts due to the use of arctic gel pads.Per follow-up information received from ibc on 30mar2022, stated that on (b)(6) 2021, the underside of both breasts had been excoriated and red, clotrimazole had been applied.The area's under the breasts had also been broken down further but currently there was granulation here and they would consider the area's to be grade 2 pd.Dressings had been applied.On (b)(6) 2022, patient was receiving active cooling treatment (arctic sun).The equipment the patient was wearing caused injury below their right breast.Equipment position altered.Gauze placed across area to minimize effects of pressure.Nurse in charge was informed and incident was investigated.Although noted that the arctic sun pads had caused a blister, it was noted that in the days running up to the incident it had been reported in the patient's nursing notes that they had severe moisture lesions and sore, friable skin under the breasts already.The patient had an ulcer under their breast that was though to be possibly due to the pads for the arctic sun machine being used to cool the patient.Reading the notes, the user stated that it was clear that the patient was already suffering from broken/ sore skin in this area in the days leading up to the incident.It was unlikely that the equipment alone caused the damage to the patient's skin.
 
Manufacturer Narrative
Upon further review, bd has determined that this mdr was reported in error as it was found to be a duplicate of an event previously reported.H11: section a through f - the information provided by bard represents all of the known information at this time.Despite good faith efforts to obtain additional information, the complainant / reporter was unable or unwilling to provide any further patient, product, or procedural details to bard.
 
Event Description
It was reported that the patient had some blisters under breasts due to the use of arctic gel pads.Per follow-up information received from ibc on 30mar2022, stated that on 17dec2021, the underside of both breasts had been excoriated and red, clotrimazole had been applied.The area's under the breasts had also been broken down further but currently there was granulation here and they would consider the area's to be grade 2 pd.Dressings had been applied.On 05jan2022, patient was receiving active cooling treatment (arctic sun).The equipment the patient was wearing caused injury below their right breast.Equipment position altered.Gauze placed across area to minimize effects of pressure.Nurse in charge was informed and incident was investigated.Although noted that the arctic sun pads had caused a blister, it was noted that in the days running up to the incident it had been reported in the patient's nursing notes that they had severe moisture lesions and sore, friable skin under the breasts already.The patient had an ulcer under their breast that was though to be possibly due to the pads for the arctic sun machine being used to cool the patient.Reading the notes, the user stated that it was clear that the patient was already suffering from broken/ sore skin in this area in the days leading up to the incident.It was unlikely that the equipment alone caused the damage to the patient's skin.
 
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Brand Name
UNKNOWN ARCTICGEL PADS
Type of Device
UNKNOWN ARCTICGEL PADS
Manufacturer (Section D)
MEDIVANCE, INC. ¿ 1725056
321 s taylor ave
suite 200
louisville 80027
Manufacturer (Section G)
MEDIVANCE, INC. ¿ 1725056
321 s taylor ave
suite 200
louisville 80027
Manufacturer Contact
juan velez
8195 industrial blvd
covington 30014
7707846100
MDR Report Key14212347
MDR Text Key290104258
Report Number1018233-2022-03006
Device Sequence Number1
Product Code DWJ
Combination Product (y/n)N
Reporter Country CodeUK
PMA/PMN Number
K142702
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Other,Health Professional
Reporter Occupation Physician
Type of Report Initial,Followup
Report Date 07/06/2022
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received04/26/2022
Is this an Adverse Event Report? Yes
Is this a Product Problem Report? No
Device Operator Health Professional
Device Catalogue NumberUNKNOWN
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? Yes
Date Manufacturer Received07/05/2022
Was Device Evaluated by Manufacturer? Device Not Returned to Manufacturer
Is the Device Single Use? Yes
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Initial
Patient Sequence Number1
Patient Outcome(s) Required Intervention;
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